Three-year effects on dietary quality of health education: a randomized controlled trial of people with screen-detected dysglycaemia (The ADDITION study, Denmark)

Eur J Public Health. 2013 Jun;23(3):393-8. doi: 10.1093/eurpub/cks076. Epub 2012 Jun 13.

Abstract

Background: Healthy diet is a core component in prevention and self-management of type 2 diabetes and cardiovascular disease. The long-term efficacy was assessed of a theory-based health education programme 'Ready to Act' on dietary quality in people with screen-detected dysglycaemia.

Methods: Five hundred and nine adults with prediabetes (impaired glucose tolerance, impaired fasting glycaemia) or type 2 diabetes were recruited through screening for type 2 diabetes [the ADDITION (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care) study, DK] and then randomly assigned to health education or to a control group (I = 322; C = 187). The intervention group was offered a 12-week programme in health-related action competence including 2 one-to-one and 8 group sessions (18 h). Dietary quality was measured by the Dietary Quality Score_revised (0-8 points) at baseline and at one- and 3-year follow-up. Changes were analysed by multilevel analyses.

Results: The analysis included data from 444 participants (87%). At the 3-year follow-up, the intervention group had significantly increased dietary quality compared with the control group (net change: 0.39 Dietary Quality Score_revised points, P = 0.04). The intake of unsaturated fats used on bread and for cooking increased in the intervention group compared with the control group at the 3-year follow-up (net change: 31 g/week; P = 0.02). A non-significant tendency toward an increased intake of vegetables in the intervention group compared with the control group was seen (net change: 111 g/week; P = 0.16). No changes were seen in fish intake.

Conclusions: Health education aiming at action competence improved the long-term dietary quality in a population with dysglycaemia, especially according to the intake of unsaturated fat. The ADDITION trial was registered at ClinicalTrials.gov ID no NCT00237549.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Cardiovascular Diseases / prevention & control
  • Cluster Analysis
  • Denmark / epidemiology
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / prevention & control
  • Diet / psychology*
  • Diet / standards*
  • Female
  • Follow-Up Studies
  • Glucose Intolerance / diagnosis
  • Glucose Intolerance / prevention & control
  • Glucose Metabolism Disorders / diagnosis*
  • Glucose Metabolism Disorders / prevention & control*
  • Glycated Hemoglobin / analysis
  • Group Processes
  • Health Behavior*
  • Health Education*
  • Health Status Disparities
  • Humans
  • Male
  • Mass Screening / psychology
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Primary Health Care / statistics & numerical data
  • Self Care
  • Social Class
  • Surveys and Questionnaires

Substances

  • Glycated Hemoglobin A

Associated data

  • ClinicalTrials.gov/NCT00237549